Provider Demographics
NPI:1639585425
Name:MOORING, MONICA DENISE (DSW, MSW)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:DENISE
Last Name:MOORING
Suffix:
Gender:F
Credentials:DSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1772
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90733-1772
Mailing Address - Country:US
Mailing Address - Phone:719-213-8773
Mailing Address - Fax:
Practice Address - Street 1:3959 MIRA LINDA PT
Practice Address - Street 2:APT. 1534
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-6907
Practice Address - Country:US
Practice Address - Phone:719-213-8773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILSW2304104100000X
HILSW-2304104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker